Iraqi vaccinators fight against enormous odds with UN help in anti-polio campaign

United Nations agencies are helping over 20,000 Iraqi mobile polio vaccinators in “a titanic effort” to reach as many as 5 million children under the age of five despite the violence raging in the strife-torn country and the added difficulty of the displacement of hundreds of thousands of people.

“Delivering polio vaccine in Iraq's violent heartland has never been harder,” the UN Children’s Fund (UNICEF) said in its latest update on the campaign. “Vaccinators working in central Iraq, where violence and suspicion are at their most intense, risk their lives to knock on doors and ask to immunize children.

“Others have to make the long and difficult trek out to temporary camps where displaced families eke out a precarious existence,” it added. “But vaccinators know that they carry the hopes and fears of Iraq’s polio eradication programme on their shoulders.”

UNICEF has provided transport for many vaccination teams in an effort to improve their security, as well as carriers to protect the vaccine vials. It has also supported a massive communication and community mobilization effort to lobby support from local leaders and families.

With more than 1 million Iraqis forced to flee their homes since early 2006, close-knit communities are now filled with strangers, their names and faces unknown to the local health teams. But no matter where these children live – whether in cities or remote rural areas, in conflict zones or temporary camps – vaccinators bring the polio vaccine right to their doorsteps, with help from UNICEF and the UN World Health Organization (WHO).

The campaign has a simple objective: to administer two drops of oral vaccine to every eligible child.

“Iraq's vaccinators are truly some of the world’s greatest champions for children, and among the least recognized,” UNICEF Iraq's Chief of Health Alexander Malyavin said. “Their courage alone has kept Iraq polio-free since 2000, despite the chaos brought by conflict and insecurity. To watch them work during a polio campaign is to understand what it means to challenge enormous odds – and beat them.”

Succeeding against the odds has become a tradition for Iraq’s polio campaigns, which have continued for the past seven years, through sanctions and war, to maintain the country’s precious polio-free status. The last round in December 2006 reached over 90 per cent of its intended target, immunizing almost 4.4 million children.

But concerns are high that as insecurity traps children in “hot zones” or forces them to flee, the most vulnerable will become harder and harder to reach. During this round, vaccinators are will make special efforts to include recently displaced children, many of whom have not been counted on the tally sheets vaccinators usually rely on to keep track of their progress.

“These children are probably the most vulnerable in Iraq today, and we’re determined to ensure they don’t miss out," Dr. Malyavin said. “The goal of the polio campaigns is every child, not just those that are easy to reach.”

Iraqi families appreciate that determination. One father put his feelings into words as his son received the two drops needed to remain polio-free for life. “God bless the vaccinators,” he said. “They are doing their very best for the protection of our children.”

In Baghdad’s Karrada district, experienced vaccinators are now struggling with impossible burdens. “Huge numbers of displaced families have moved into this area because of violence in their neighbourhoods,” said Alyaa Ahmed Aziz, manager of the local primary health care centre. “You can imagine the load on the vaccinators who were already required to cover a large number of children living here Karrada even before the conflict.”